狼疮脑病.doc

狼疮脑病 Case Definitions for Neuropsychiatric Syndromes in Systemic Lupus Erythematosus 系统性红斑狼疮神经精神综合征的定义 Acute Inflammatory Demyelinating Polyradiculoneuropathy (Guillain-Barr é Syndrome) 急性炎症性多神经根脱髓鞘性神经病( Guillain-Barre 综合征) Acute, inflammatory, and demyelinating syndrome of spinal roots, peripheral, and occasionally cranial nerves. 脊神经根和外周神经的急性炎症性脱髓鞘综合征,有时也累及颅神经。 Diagnostic criteria: 诊断标准: A. Clinical features 临床特点 1. Progressive polyradiculoneuropathy, usually ascending and predominantly motor, which peaks usually within 21 days or less 进行性多神经根神经病,主要累及运动神经,通常由下而上发展,在 21 天或更少的时间内达到疾病高峰 2. Reflex loss 反射减退 3. Symmetric, may involve the trunk and may cause respiratory failure 对称性发病,可累及躯干并引起呼吸衰竭 B. CSF 脑脊液 Increased CSF protein without pleocytosis 脑脊液蛋白含量增高而不伴有细胞数增多 C. Supportive evidence by nerve conduction study (NCS) including F-wave ascertainment whereby there is≥1 abnormality in≥3 nerves (1) 包括F 波测量的神经传导检查至少在3 根神经上发现有1 个以上的异常表现 The abnormalities are: 这些异常表现包括: ? Conduction block in which the amplitude pound muscle action potential diminishes with more proximal sites of nerve stimulation 传导阻滞, 表现为由近端神经刺激所产生的复合肌肉动作电位幅度减小?F waves may be absent or prolonged F 波缺失延长? Slowing of conduction velocity 传导速度减慢? Prolongation of distal latencies 远端潜伏期延长 NB: Nerve conduction abnormalities may be subtle in early stages and may need to be repeated. 注意: 神经传导异常在疾病早期可以很轻微,可能需要重复检查。 Exclusions: 排除: ? Acute spinal cord disease 急性脊髓疾病? Botulism 肉毒中毒? Poliomyelitis and other infections 脊髓灰质炎和其它感染? Acute myasthenia gravis 重症肌无力 Ascertainment: 确诊: By history, physical examination, electrophysiologic study, and CSF examination 通过病史询问、体格检查、电生理学和脑脊液检查 Aseptic Meningitis 无菌性脑膜炎 Syndrome of fever, headache, and meningeal irritation with CSF pleocytosis, and negative CSF cultures. 有发热、头痛、脑膜刺激症,脑脊液细胞数增多,脑脊液培养阴性。 Diagnostic criteria: All the following: 具有以下所有表现 A. Acute or subacute onset of headache with photophobia, neck stiffness, and fever 伴有畏光、颈项强直和发热的急性或亚急性头痛发作 B. Signs of meningeal irritati